Published in PLOS One on 2026-05-07, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Aqbara Ibrahim Chande, Novatus A Tesha, Bruno Sunguya, Hamufare Mugauri
Source: PLOS One • DOI 10.1371/journal.pone.0348862
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
High viral load indicates poor treatment outcomes among people living with HIV (PLHIV) on antiretroviral therapy (ART). However, there is a dearth of evidence on specific factors associated with high viral load in resource-limited settings, including Tanzania.
The aim of this study is to identify factors contributing to high viral load among PLHIV aged 15 years and older on ART for at least six months in Tanga, Tanzania.
This is analytical cross-sectional study of 233 PLHIV attending the Care and Treatment Centre (CTC) in Tanga region from September to November 2023. A systematic sampling method was used to select participants for face-to-face interviews. A structured questionnaire was used to collect socio-demographic information while clinical data were collected from the patients’ records and CTC database. Descriptive analysis was used to estimate the prevalence of high viral load, while Pearson Chi-square tests compared categorical variables, and the logistic regression assessed determinants of high viral load.
High viral load was prevalent among 35.2% [95% CI: 29.3%−41.6%] PLHIV attending CTC in Tanga region. Higher viral load was noted among younger adults (52.5%), those in sales/services (63.6%), professionals (54.5%), and unskilled workers (53.2%) compared to their counterparts. PLHIV with severe food insecurity were more likely to exhibit higher viral load compared to those from food secure households (AOR = 9.6; 95% CI: 2.6–35.2). Those consuming alcohol were 4.2 times more likely to have a higher viral load compared to non-drinkers (AOR = 4.2; 95% CI: 1.4–12.5). PLHIV aged 20–24 were 5.4 times more likely to exhibit elevated viral load levels compared to their older counterparts (AOR = 5.4; 95% CI: 1.8–15.7). Additionally, PLHIV in sales and services occupations were 6.1 times more likely to have a higher viral load compared to those in agriculture (AOR = 6.1; 95% CI: 1.1–35 and those facing high stigma were 4.3 times more likely to have a higher HVL than individuals with good social support and low stigma (AOR = 4.3, 95% CI: 1.0–18.7, p = 0.049).).
More than one in three adult PLHIV on ART in Tanga Tanzania had a high viral load. This burden highlights a steep climb to reach the last 95 target ahead of the deadline. Efforts should focus on young adults, those with households’ food insecurity, consuming alcohol, and with perceived stigma in Tanzania and areas with similar context.
Background
To combat the burden of HIV, the joint United Nations Programme on HIV/AIDS(UNAIDS) launched the “95-95-95” targets in 2015 [1]. The third 95 focuses on viral suppression, where only 53% had reached the agreed target globally [2]. Addressing the non-viral suppression can mitigate the burden of advanced HIV disease, prolong the lives of People Living with HIV (PHLIV), and therefore HIV transmissibility. Advanced HIV disease defined as clinical stages 3 or 4 is marked by severe symptoms like opportunistic infections and significant weight loss, alongside a CD4 count below 200 cells/mm³ [3]. Viral Load Suppression (VLS) is a crucial marker of treatment efficacy in HIV-positive patients and is considered achieved when the reading is less than 1,000 HIV RNA copies/mL of plasma. Despite the effective implementation of Antiretroviral Therapy (ART) initiatives in countries with high burden [4], individuals suffering from advanced HIV disease continue to present to hospitals, and as a result, medical admissions and deaths due to HIV-related infectious diseases remain high.
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Aqbara Ibrahim Chande, Novatus A Tesha, Bruno Sunguya, Hamufare Mugauri. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
Explore connected evidence
- Evidence brief: Evaluating the effects of community-based programs on viral rebound and viral suppression among HIV-positive orphaned and vulnerable children receiving antiretroviral treatment: Findings from the ACHIEVE project in Tanzania
- Evidence brief: Chronic kidney disease screening and associated factors among people living with HIV on anti-retroviral therapy in Dar Es Salaam, Tanzania: Hospital-based cross-sectional study
- Evidence brief: HIV and Hepatitis B co-infection in Tanzania: Analysis of the 2022–2023 Tanzania HIV Impact Survey
